Application of two types of multi-angle plate in the treatment of metacarpal and phalangeal fractures: a clinical observation

Objective To evaluate the clinical efficacy of two types of multi-angle plates in treating comminuted metacarpal and phalangeal fractures.Methods From January 2010 to September 2012,58 patients with 66 mild comminuted metacarpal or phalangeal fractures were treated with internal fixation using two types of multi-angle plate (wing-shaped and ladder-shaped).Bone union time and postoperative functional recovery were compared between the two groups.Results All the cases were follow-up for 4 to 18 months.X-ray evidence of fracture healing was seen between 9 and 15 weeks (average,12.3 weeks) postoperatively in the wing-shaped plate group,and between 9 and 13 weeks (average,11.2 weeks) in the ladder-shaped plate group.The difference was statistically significant.Based on total active motion evaluation system the results in the wingshaped plate group were excellent in 14 fractures,good in 12 fractures,fair in 3 fractures,and poor in 2 fractures.The results in the ladder-shaped plate group were excellent in 18 fractures,good in 14 fractures,fair in 2 fractures and poor in 1 fracture.The overall satisfactory rate was 83.87％ in the former and 91.43％ in the latter,the difference being statistically significant.Conclusion The multi-angle plates can achieve accurate fixation of mild comminuted metacarpal and phalangeal fractures,which allows early postoperative functional exercise that leads to satisfactory functional outcomes. Key words: Fractures,bone;  Internal fixator;  Plates;  Metacarpal bones;  Finger phalanges